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In our area of California, hourly rates through agencies for caregivers are about $28-33/hour with a minimum of 4 hours/day. There is no discount for 24 hour care, it is just multiplied. Though you could hire a person privately and pay them a salary, but you'd function as an employer and be responsible for their social security taxes, state and federal taxes, other deductions and in our state, their health insurance plus you'd be liable for any potential injury they might suffer while caring for your loved one. Due to all that, in my opinion it is better to go through an agency that covers all that. So to make the math easier if you use the round number of $30/hour for 24 hours a day, that's $720/day x 30 days equals $21,600/month. That's two and a half to three times as much as the best board and care homes I've seen lately with 24 hour awake care. I've visited very nice ones that range from $6,000 - 9,000/mo which is less than private care, and less than memory care units. Care levels run from assisted living to dementia care and hospice.
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cskrno Sep 2022
I did this exact same math calculation when trying to come up with ways for my 97 year old mother to be able to stay in her own home. I had reached my limits in providing her care. The hourly people who came in often didn't show, cancelled or wanted to change their schedule. I was really surprised at how many people asked why I didn't just hire "a nurse or someone" to go into the home to care for her full time. I also did not feel comfortable becoming an employer and finding the right person for her care (and you'd have to have more than one), The $4,600 a month for her assisted living facility seems expensive until you compare it to the $20,000/month for hourly caregivers. The facility is FAR from perfect but the best solution I could find. It is private pay of course.
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There is a huge demand for home health aides regardless of private pay or covered by Medicaid. Sadly, most of these folks are not high skilled and certainly they are not RNs. Of course many home health aides are dedicated and loving, but it can be a crap shoot of who you get and do they stick around, cancel all the time, or quit w/no back up. In theory an aide from an agency is better, in that the agency has vetted them AND in theory the agency can provide back up due to a cancellation.

Aides can help with things such as dressing, bathing, providing company, helping provide meals and most only come for a few hours only a few times per week. If 24/7 around the clock is needed (the loved one cannot toilet on their own, cannot cook or feed themselves adequately, cannot mananage their own medications, they are NOT safe to be alone at all, on and on) then high level assistive living (private pay at about $15-18K a month, no Medicaid coverage for this) or nursing home placement (about $12-$15K a month, may be private pay at first and Medicaid may take over after a spend down -- PS Medicare pays for neither).

Private nursing (an RN) if actual medical care is needed, IVs, wound care, or other "more medical services" runs about $150.00 an hour, that's over $1K a day and JUST for an 8 hour shift. Obviously unless someone has many, many millions, full time 24/7 private nursing is not realistic. A friend was able to find a top qualify private aid (not an RN) who agreed to take $1K a day cash (I know, not really legit but) to be there 24/7 for the few remaining weeks of her other half's life. So there are ways -- w/lots of $ -- to work out expensive short term arrangements if there is a crisis or end of life situation.

And sorry, forget Medicaid-covered home health aides. Even if one has spent down and qualifies for Medicaid; there are huge waiting times (wait list) for Medicaid-paid home health aides. Where we live our elder care lawyer advised the wait time is 5 YEARS!.....

With the Baby Boom generation aging, this is going to be worse and worse. Start planing for yourself now even before you have worked out what to do with mom or dad!
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LindaC11 Sep 2022
Hi.
wont Medicaid pay a family member or friend to care for a senior?
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It costs what the market will bear. Some care might be available through Medicaid if the person qualifies. Contact your local area agency on aging to see what services might be available.
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It depends on where you live, if you hire privately or through an agency. It will depend on what type of caregiver you need. Are there medications that need to be given? Can the person take the meds or do they have to be given? Are there wounds that need to be dressed? There are a lot of factors that go into what kind of caregiver and that will effect cost.
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Oh I feel for everyone these days. Long ago I started taking care of a friends parents and it evolved into me being a live-in manager, 24/7 care, and including myself we were a staff of six. We topped out at paying $15 an hour. We eventually paid overtime for some of the major holidays during the year. That was so that I could get a break. Yes, these caregivers have us by the balls. They do change their schedules, not show up, do a half ass job, and you’re stuck doing it when you had other plans. I loved these people but I’ll be honest it’s the hardest job I ever had. And when you need a break you need a break! ❤️ I know that was not helpful really I’m just being supportive! What are we going to do when we need this kind of help? I shudder.
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Here in Connecticut, we pay $30.50/hr ($31.50 on weekends) to an agency for a personal care attendant (PCA), with a 2-hr minimum. The caregivers don't even see half of that. Unfortunately we've had a couple negative experiences with private pay caregivers so we're sticking with the agency route for now.
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We pay $20 an hour here in New Jersey. Private...no agency. It's better to go private because you have consistency. That's always better for the person being cared for. The agencies are a complete racket as they give very little to the aide. This is why they go through them like water.
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we're paying $500.00 per day.
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Babyluvsu2 Sep 2022
WOW!!! There ought to be a law. My sister told me that about a gentleman she was caring for and I simply did not believe her. But I guess it's so. He was wealthy and perhaps it's the same for you.

There ought to be a law! Seriously.
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Where I live the minimum, for general ADL care is $30/hour with a 4 hour minimum. For more medical or nursing care it is $100-120/hour.
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$25 private pay, $30 to a small agency
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